Olanzapine for the Treatment of Psychosis in Patients With Parkinsons Disease and Dementia
Identifieur interne : 002685 ( Main/Corpus ); précédent : 002684; suivant : 002686Olanzapine for the Treatment of Psychosis in Patients With Parkinsons Disease and Dementia
Auteurs : Laura Marsh ; Constantine Lyketsos ; Stephen G. ReichSource :
- Psychosomatics [ 0033-3182 ] ; 2001.
Abstract
Psychotic symptoms are a common complication in Parkinsons disease with dementia. The authors conducted an open-label 6-week trial of olanzapine preceded by a placebo lead-in in five subjects with Parkinsons disease, mild to moderately severe dementia, and psychosis. Four of the subjects terminated the trial early because of worsening motor function, sedation, or paranoia. There was no improvement in psychotic symptoms, and functional abilities declined significantly. Olanzapine appears to be poorly tolerated in patients with Parkinsons disease, psychotic symptoms, and dementia.
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DOI: 10.1176/appi.psy.42.6.477
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<record><TEI wicri:istexFullTextTei="biblStruct"><teiHeader><fileDesc><titleStmt><title xml:lang="en">Olanzapine for the Treatment of Psychosis in Patients With Parkinsons Disease and Dementia</title><author><name sortKey="Marsh, Laura" sort="Marsh, Laura" uniqKey="Marsh L" first="Laura" last="Marsh">Laura Marsh</name><affiliation><mods:affiliation>Morris K. Udall Parkinsons Disease Research Center of Excellence at Johns Hopkins, the Neuropsychiatry Service, Department of Psychiatry and Behavioral Sciences, Baltimore, MDMovement Disorders Center, Department of Neurology, Johns Hopkins University School of Medicine, Johns Hopkins University, Baltimore, MD</mods:affiliation></affiliation></author><author><name sortKey="Lyketsos, Constantine" sort="Lyketsos, Constantine" uniqKey="Lyketsos C" first="Constantine" last="Lyketsos">Constantine Lyketsos</name><affiliation><mods:affiliation>Morris K. Udall Parkinsons Disease Research Center of Excellence at Johns Hopkins, the Neuropsychiatry Service, Department of Psychiatry and Behavioral Sciences, Baltimore, MDMovement Disorders Center, Department of Neurology, Johns Hopkins University School of Medicine, Johns Hopkins University, Baltimore, MD</mods:affiliation></affiliation></author><author><name sortKey="Reich, Stephen G" sort="Reich, Stephen G" uniqKey="Reich S" first="Stephen G." last="Reich">Stephen G. Reich</name><affiliation><mods:affiliation>Morris K. Udall Parkinsons Disease Research Center of Excellence at Johns Hopkins, the Neuropsychiatry Service, Department of Psychiatry and Behavioral Sciences, Baltimore, MDMovement Disorders Center, Department of Neurology, Johns Hopkins University School of Medicine, Johns Hopkins University, Baltimore, MD</mods:affiliation></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">ISTEX</idno><idno type="RBID">ISTEX:F7524C782E5194C3851FAFC6DC9A9B0EB916ED3F</idno><date when="2011" year="2011">2011</date><idno type="doi">10.1176/appi.psy.42.6.477</idno><idno type="url">https://api.istex.fr/document/F7524C782E5194C3851FAFC6DC9A9B0EB916ED3F/fulltext/pdf</idno><idno type="wicri:Area/Main/Corpus">002685</idno></publicationStmt><sourceDesc><biblStruct><analytic><title level="a" type="main" xml:lang="en">Olanzapine for the Treatment of Psychosis in Patients With Parkinsons Disease and Dementia</title><author><name sortKey="Marsh, Laura" sort="Marsh, Laura" uniqKey="Marsh L" first="Laura" last="Marsh">Laura Marsh</name><affiliation><mods:affiliation>Morris K. Udall Parkinsons Disease Research Center of Excellence at Johns Hopkins, the Neuropsychiatry Service, Department of Psychiatry and Behavioral Sciences, Baltimore, MDMovement Disorders Center, Department of Neurology, Johns Hopkins University School of Medicine, Johns Hopkins University, Baltimore, MD</mods:affiliation></affiliation></author><author><name sortKey="Lyketsos, Constantine" sort="Lyketsos, Constantine" uniqKey="Lyketsos C" first="Constantine" last="Lyketsos">Constantine Lyketsos</name><affiliation><mods:affiliation>Morris K. Udall Parkinsons Disease Research Center of Excellence at Johns Hopkins, the Neuropsychiatry Service, Department of Psychiatry and Behavioral Sciences, Baltimore, MDMovement Disorders Center, Department of Neurology, Johns Hopkins University School of Medicine, Johns Hopkins University, Baltimore, MD</mods:affiliation></affiliation></author><author><name sortKey="Reich, Stephen G" sort="Reich, Stephen G" uniqKey="Reich S" first="Stephen G." last="Reich">Stephen G. Reich</name><affiliation><mods:affiliation>Morris K. Udall Parkinsons Disease Research Center of Excellence at Johns Hopkins, the Neuropsychiatry Service, Department of Psychiatry and Behavioral Sciences, Baltimore, MDMovement Disorders Center, Department of Neurology, Johns Hopkins University School of Medicine, Johns Hopkins University, Baltimore, MD</mods:affiliation></affiliation></author></analytic><monogr></monogr><series><title level="j">Psychosomatics</title><title level="j" type="abbrev">PSYM</title><idno type="ISSN">0033-3182</idno><imprint><publisher>ELSEVIER</publisher><date type="published" when="2001">2001</date><biblScope unit="volume">42</biblScope><biblScope unit="issue">6</biblScope><biblScope unit="page" from="477">477</biblScope><biblScope unit="page" to="481">481</biblScope></imprint><idno type="ISSN">0033-3182</idno></series><idno type="istex">F7524C782E5194C3851FAFC6DC9A9B0EB916ED3F</idno><idno type="DOI">10.1176/appi.psy.42.6.477</idno><idno type="PII">S0033-3182(01)70454-9</idno></biblStruct></sourceDesc><seriesStmt><idno type="ISSN">0033-3182</idno></seriesStmt></fileDesc><profileDesc><textClass></textClass><langUsage><language ident="en">en</language></langUsage></profileDesc></teiHeader><front><div type="abstract">Psychotic symptoms are a common complication in Parkinsons disease with dementia. The authors conducted an open-label 6-week trial of olanzapine preceded by a placebo lead-in in five subjects with Parkinsons disease, mild to moderately severe dementia, and psychosis. Four of the subjects terminated the trial early because of worsening motor function, sedation, or paranoia. There was no improvement in psychotic symptoms, and functional abilities declined significantly. Olanzapine appears to be poorly tolerated in patients with Parkinsons disease, psychotic symptoms, and dementia.</div></front></TEI><istex><corpusName>elsevier</corpusName><author><json:item><name>Laura Marsh M.D.</name><affiliations><json:string>Morris K. Udall Parkinsons Disease Research Center of Excellence at Johns Hopkins, the Neuropsychiatry Service, Department of Psychiatry and Behavioral Sciences, Baltimore, MDMovement Disorders Center, Department of Neurology, Johns Hopkins University School of Medicine, Johns Hopkins University, Baltimore, MD</json:string></affiliations></json:item><json:item><name>Constantine Lyketsos M.D.</name><affiliations><json:string>Morris K. Udall Parkinsons Disease Research Center of Excellence at Johns Hopkins, the Neuropsychiatry Service, Department of Psychiatry and Behavioral Sciences, Baltimore, MDMovement Disorders Center, Department of Neurology, Johns Hopkins University School of Medicine, Johns Hopkins University, Baltimore, MD</json:string></affiliations></json:item><json:item><name>Stephen G. Reich M.D.</name><affiliations><json:string>Morris K. Udall Parkinsons Disease Research Center of Excellence at Johns Hopkins, the Neuropsychiatry Service, Department of Psychiatry and Behavioral Sciences, Baltimore, MDMovement Disorders Center, Department of Neurology, Johns Hopkins University School of Medicine, Johns Hopkins University, Baltimore, MD</json:string></affiliations></json:item></author><language><json:string>eng</json:string></language><abstract>Psychotic symptoms are a common complication in Parkinsons disease with dementia. The authors conducted an open-label 6-week trial of olanzapine preceded by a placebo lead-in in five subjects with Parkinsons disease, mild to moderately severe dementia, and psychosis. Four of the subjects terminated the trial early because of worsening motor function, sedation, or paranoia. There was no improvement in psychotic symptoms, and functional abilities declined significantly. Olanzapine appears to be poorly tolerated in patients with Parkinsons disease, psychotic symptoms, and dementia.</abstract><qualityIndicators><score>5.014</score><pdfVersion>1.7</pdfVersion><pdfPageSize>612 x 792 pts (letter)</pdfPageSize><refBibsNative>true</refBibsNative><keywordCount>0</keywordCount><abstractCharCount>585</abstractCharCount><pdfWordCount>2042</pdfWordCount><pdfCharCount>14300</pdfCharCount><pdfPageCount>5</pdfPageCount><abstractWordCount>81</abstractWordCount></qualityIndicators><title>Olanzapine for the Treatment of Psychosis in Patients With Parkinsons Disease and Dementia</title><pii><json:string>S0033-3182(01)70454-9</json:string></pii><genre><json:string>research-article</json:string></genre><host><volume>42</volume><pii><json:string>S0033-3182(01)X7027-8</json:string></pii><pages><last>481</last><first>477</first></pages><issn><json:string>0033-3182</json:string></issn><issue>6</issue><genre><json:string>Journal</json:string></genre><language><json:string>unknown</json:string></language><title>Psychosomatics</title><publicationDate>2001</publicationDate></host><categories><wos><json:string>PSYCHIATRY</json:string><json:string>PSYCHOLOGY</json:string></wos></categories><publicationDate>2001</publicationDate><copyrightDate>2011</copyrightDate><doi><json:string>10.1176/appi.psy.42.6.477</json:string></doi><id>F7524C782E5194C3851FAFC6DC9A9B0EB916ED3F</id><fulltext><json:item><original>true</original><mimetype>application/pdf</mimetype><extension>pdf</extension><uri>https://api.istex.fr/document/F7524C782E5194C3851FAFC6DC9A9B0EB916ED3F/fulltext/pdf</uri></json:item><json:item><original>true</original><mimetype>text/plain</mimetype><extension>txt</extension><uri>https://api.istex.fr/document/F7524C782E5194C3851FAFC6DC9A9B0EB916ED3F/fulltext/txt</uri></json:item><json:item><original>false</original><mimetype>application/zip</mimetype><extension>zip</extension><uri>https://api.istex.fr/document/F7524C782E5194C3851FAFC6DC9A9B0EB916ED3F/fulltext/zip</uri></json:item><istex:fulltextTEI uri="https://api.istex.fr/document/F7524C782E5194C3851FAFC6DC9A9B0EB916ED3F/fulltext/tei"><teiHeader><fileDesc><titleStmt><title level="a" type="main" xml:lang="en">Olanzapine for the Treatment of Psychosis in Patients With Parkinsons Disease and Dementia</title></titleStmt><publicationStmt><authority>ISTEX</authority><publisher>ELSEVIER</publisher><availability><p>ELSEVIER</p></availability><date>2011</date></publicationStmt><notesStmt><note type="content">Figure 1:</note><note type="content">Table 1: Demographic features and effects of olanzapine on secondary outcome measures</note></notesStmt><sourceDesc><biblStruct type="inbook"><analytic><title level="a" type="main" xml:lang="en">Olanzapine for the Treatment of Psychosis in Patients With Parkinsons Disease and Dementia</title><author><persName><forename type="first">Laura</forename><surname>Marsh</surname></persName><roleName type="degree">M.D.</roleName><note type="biography">Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, 600 N Wolfe St. Baltimore, MD 21287.</note><affiliation>Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, 600 N Wolfe St. Baltimore, MD 21287.</affiliation><affiliation>Morris K. Udall Parkinsons Disease Research Center of Excellence at Johns Hopkins, the Neuropsychiatry Service, Department of Psychiatry and Behavioral Sciences, Baltimore, MDMovement Disorders Center, Department of Neurology, Johns Hopkins University School of Medicine, Johns Hopkins University, Baltimore, MD</affiliation></author><author><persName><forename type="first">Constantine</forename><surname>Lyketsos</surname></persName><roleName type="degree">M.D.</roleName><affiliation>Morris K. Udall Parkinsons Disease Research Center of Excellence at Johns Hopkins, the Neuropsychiatry Service, Department of Psychiatry and Behavioral Sciences, Baltimore, MDMovement Disorders Center, Department of Neurology, Johns Hopkins University School of Medicine, Johns Hopkins University, Baltimore, MD</affiliation></author><author><persName><forename type="first">Stephen G.</forename><surname>Reich</surname></persName><roleName type="degree">M.D.</roleName><affiliation>Morris K. Udall Parkinsons Disease Research Center of Excellence at Johns Hopkins, the Neuropsychiatry Service, Department of Psychiatry and Behavioral Sciences, Baltimore, MDMovement Disorders Center, Department of Neurology, Johns Hopkins University School of Medicine, Johns Hopkins University, Baltimore, MD</affiliation></author></analytic><monogr><title level="j">Psychosomatics</title><title level="j" type="abbrev">PSYM</title><idno type="pISSN">0033-3182</idno><idno type="PII">S0033-3182(01)X7027-8</idno><imprint><publisher>ELSEVIER</publisher><date type="published" when="2001"></date><biblScope unit="volume">42</biblScope><biblScope unit="issue">6</biblScope><biblScope unit="page" from="477">477</biblScope><biblScope unit="page" to="481">481</biblScope></imprint></monogr><idno type="istex">F7524C782E5194C3851FAFC6DC9A9B0EB916ED3F</idno><idno type="DOI">10.1176/appi.psy.42.6.477</idno><idno type="PII">S0033-3182(01)70454-9</idno></biblStruct></sourceDesc></fileDesc><profileDesc><creation><date>2011</date></creation><langUsage><language ident="en">en</language></langUsage><abstract><p>Psychotic symptoms are a common complication in Parkinsons disease with dementia. The authors conducted an open-label 6-week trial of olanzapine preceded by a placebo lead-in in five subjects with Parkinsons disease, mild to moderately severe dementia, and psychosis. Four of the subjects terminated the trial early because of worsening motor function, sedation, or paranoia. There was no improvement in psychotic symptoms, and functional abilities declined significantly. Olanzapine appears to be poorly tolerated in patients with Parkinsons disease, psychotic symptoms, and dementia.</p></abstract></profileDesc><revisionDesc><change when="2001-07-19">Registration</change><change when="2001-06-28">Modified</change><change when="2001">Published</change></revisionDesc></teiHeader></istex:fulltextTEI></fulltext><metadata><istex:metadataXml wicri:clean="Elsevier doc found" wicri:toSee="Elsevier, no converted or simple article"><istex:xmlDeclaration>version="1.0" encoding="utf-8"</istex:xmlDeclaration><istex:docType PUBLIC="-//ES//DTD journal article DTD version 5.1.0//EN//XML" URI="art510.dtd" name="istex:docType"><istex:entity SYSTEM="gr1" NDATA="IMAGE" name="gr1"></istex:entity></istex:docType><istex:document><article version="5.1" xml:lang="en" docsubtype="fla"><item-info><jid>PSYM</jid><aid>70454</aid><ce:pii>S0033-3182(01)70454-9</ce:pii><ce:doi>10.1176/appi.psy.42.6.477</ce:doi><ce:copyright type="other" year="2011">The Academy of Psychosomatic Medicine</ce:copyright></item-info><ce:floats><ce:figure id="fig0005"><ce:label>Figure 1</ce:label><ce:link locator="gr1"></ce:link></ce:figure><ce:table id="tbl0005" frame="topbot" rowsep="0" colsep="0"><ce:label>Table 1</ce:label><ce:caption><ce:simple-para id="spar0010">Demographic features and effects of olanzapine on secondary outcome measures</ce:simple-para></ce:caption><tgroup cols="17"><colspec colname="col1"></colspec><colspec colname="col2"></colspec><colspec colname="col3"></colspec><colspec colname="col4"></colspec><colspec colname="col5"></colspec><colspec colname="col6"></colspec><colspec colname="col7"></colspec><colspec colname="col8"></colspec><colspec colname="col9"></colspec><colspec colname="col10"></colspec><colspec colname="col11"></colspec><colspec colname="col12"></colspec><colspec colname="col13"></colspec><colspec colname="col14"></colspec><colspec colname="col15"></colspec><colspec colname="col16"></colspec><colspec colname="col17"></colspec><thead valign="top"><row rowsep="1"><entry morerows="1" align="left" valign="middle">Subject</entry><entry morerows="1" align="center" valign="middle">Age</entry><entry morerows="1" align="center" valign="middle">Duration of PD, (years)</entry><entry morerows="1" align="center" valign="middle">Mattis DRS<ce:cross-ref refid="bib0060"><ce:sup>12</ce:sup></ce:cross-ref> Total Score</entry><entry morerows="1" align="center" valign="middle">Daily L-Dopa Dose, (mg)</entry><entry morerows="1" align="center" valign="middle">Mean Olanzapine Dose, mg</entry><entry morerows="1" align="center" valign="middle">Days on Olanzapine</entry><entry namest="col8" nameend="col9" rowsep="1" align="center">BPRS</entry><entry namest="col10" nameend="col11" rowsep="1" align="center">NPI Total Symptom Severity</entry><entry namest="col12" nameend="col13" rowsep="1" align="center">NPI Caregiver Distress</entry><entry namest="col14" nameend="col15" rowsep="1" align="center">MMSE</entry><entry namest="col16" nameend="col17" rowsep="1" align="center">Nocturnal Sleep (hours)</entry></row><row rowsep="1"><entry align="center">Pre</entry><entry align="center">Post</entry><entry align="center">Pre</entry><entry align="center">Post</entry><entry align="center">Pre</entry><entry align="center">Post</entry><entry align="center">Pre</entry><entry align="center">Post</entry><entry align="center">Pre</entry><entry align="center">Post</entry></row></thead><tbody><row><entry align="left">1</entry><entry align="char" char=".">72</entry><entry align="char" char=".">9</entry><entry align="char" char=".">110</entry><entry align="char" char=".">1,400</entry><entry align="char" char=".">2.9</entry><entry align="char" char=".">42</entry><entry align="char" char=".">40</entry><entry align="char" char=".">39</entry><entry align="char" char=".">38</entry><entry align="char" char=".">33</entry><entry align="char" char=".">19</entry><entry align="char" char=".">18</entry><entry align="char" char=".">23</entry><entry align="char" char=".">26</entry><entry align="char" char=".">8.3</entry><entry align="char" char=".">8.2</entry></row><row><entry align="left">2</entry><entry align="char" char=".">70</entry><entry align="char" char=".">15</entry><entry align="char" char=".">128</entry><entry align="char" char=".">3,000</entry><entry align="char" char=".">2.5‘</entry><entry align="char" char=".">14</entry><entry align="char" char=".">34</entry><entry align="char" char=".">33<ce:cross-ref refid="tblfn0005"><ce:sup>*</ce:sup></ce:cross-ref></entry><entry align="char" char=".">45</entry><entry align="char" char=".">93</entry><entry align="char" char=".">28</entry><entry align="char" char=".">37</entry><entry align="char" char=".">25</entry><entry align="char" char=".">22<ce:cross-ref refid="tblfn0005"><ce:sup>*</ce:sup></ce:cross-ref></entry><entry align="char" char=".">4</entry><entry align="char" char=".">2.6</entry></row><row><entry align="left">3</entry><entry align="char" char=".">65</entry><entry align="char" char=".">21</entry><entry align="char" char=".">138</entry><entry align="char" char=".">1,650</entry><entry align="char" char=".">3.8</entry><entry align="char" char=".">15</entry><entry align="char" char=".">60</entry><entry align="char" char=".">63</entry><entry align="char" char=".">48</entry><entry align="char" char=".">73</entry><entry align="char" char=".">35</entry><entry align="char" char=".">33</entry><entry align="char" char=".">27</entry><entry align="char" char=".">29</entry><entry align="char" char=".">3</entry><entry align="char" char=".">2.9</entry></row><row><entry align="left">4</entry><entry align="char" char=".">76</entry><entry align="char" char=".">9</entry><entry align="char" char=".">72</entry><entry align="char" char=".">600</entry><entry align="char" char=".">2.5</entry><entry align="char" char=".">7</entry><entry align="char" char=".">33</entry><entry align="char" char=".">47</entry><entry align="char" char=".">21</entry><entry align="char" char=".">28</entry><entry align="char" char=".">4</entry><entry align="char" char=".">9</entry><entry align="char" char=".">16</entry><entry align="char" char=".">17</entry><entry align="char" char=".">7.5</entry><entry align="char" char=".">8.9</entry></row><row><entry align="left">5</entry><entry align="char" char=".">76</entry><entry align="char" char=".">6</entry><entry align="char" char=".">119</entry><entry align="char" char=".">1,100</entry><entry align="char" char=".">3.1</entry><entry align="char" char=".">24</entry><entry align="char" char=".">39</entry><entry align="char" char=".">30<ce:cross-ref refid="tblfn0005"><ce:sup>*</ce:sup></ce:cross-ref></entry><entry align="char" char=".">47</entry><entry align="char" char=".">11<ce:cross-ref refid="tblfn0005"><ce:sup>*</ce:sup></ce:cross-ref></entry><entry align="char" char=".">7</entry><entry align="char" char=".">2<ce:cross-ref refid="tblfn0005"><ce:sup>*</ce:sup></ce:cross-ref></entry><entry align="char" char=".">24</entry><entry align="char" char=".">23<ce:cross-ref refid="tblfn0005"><ce:sup>*</ce:sup></ce:cross-ref></entry><entry align="char" char=".">7.9</entry><entry align="char" char=".">9.8<ce:cross-ref refid="tblfn0005"><ce:sup>*</ce:sup></ce:cross-ref></entry></row><row><entry align="center">Mean±SD</entry><entry align="char" char="±">71.8<ce:hsp sp="0.25"></ce:hsp>±4.6<ce:hsp sp="0.25"></ce:hsp></entry><entry align="char" char="±">12.0<ce:hsp sp="0.25"></ce:hsp>±6.0<ce:hsp sp="0.25"></ce:hsp></entry><entry align="char" char="±">113.4<ce:hsp sp="0.25"></ce:hsp>±25.4<ce:hsp sp="0.25"></ce:hsp></entry><entry align="char" char="±">1550<ce:hsp sp="0.25"></ce:hsp>±900<ce:hsp sp="0.25"></ce:hsp></entry><entry align="char" char="±">2.6<ce:hsp sp="0.25"></ce:hsp>±1.3<ce:hsp sp="0.25"></ce:hsp></entry><entry align="char" char="±">20.4<ce:hsp sp="0.25"></ce:hsp>±13.5<ce:hsp sp="0.25"></ce:hsp></entry><entry align="char" char="±">41.2<ce:hsp sp="0.25"></ce:hsp>±10.9<ce:hsp sp="0.25"></ce:hsp></entry><entry align="char" char="±">42.4<ce:hsp sp="0.25"></ce:hsp>±13.2<ce:hsp sp="0.25"></ce:hsp></entry><entry align="char" char="±">39.8<ce:hsp sp="0.25"></ce:hsp>±41.2<ce:hsp sp="0.25"></ce:hsp></entry><entry align="char" char="±">47.6<ce:hsp sp="0.25"></ce:hsp>±34.1<ce:hsp sp="0.25"></ce:hsp></entry><entry align="char" char="±">18.6<ce:hsp sp="0.25"></ce:hsp>±13.3<ce:hsp sp="0.25"></ce:hsp></entry><entry align="char" char="±">19.8<ce:hsp sp="0.25"></ce:hsp>±15.1<ce:hsp sp="0.25"></ce:hsp></entry><entry align="char" char="±">23.0<ce:hsp sp="0.25"></ce:hsp>±4.2<ce:hsp sp="0.25"></ce:hsp></entry><entry align="char" char="±">23.4<ce:hsp sp="0.25"></ce:hsp>±4.5<ce:hsp sp="0.25"></ce:hsp></entry><entry align="char" char="±">6.1<ce:hsp sp="0.25"></ce:hsp>±2.5<ce:hsp sp="0.25"></ce:hsp></entry><entry align="char" char="±">6.5<ce:hsp sp="0.25"></ce:hsp>±3.5<ce:hsp sp="0.25"></ce:hsp></entry></row></tbody></tgroup><ce:legend><ce:simple-para id="spar0015">Note: DRS = Dementia Rating Scale; BPRS = Brief Psychiatric Rating Scale; NPI = Neuropsychiatric Inventory; MMSE = Mini-Mental State Exam.</ce:simple-para></ce:legend><ce:table-footnote id="tblfn0005"><ce:label>*</ce:label><ce:note-para>Value obtained at assessment prior to withdrawal from the study</ce:note-para></ce:table-footnote></ce:table></ce:floats><head><ce:title>Olanzapine for the Treatment of Psychosis in Patients With Parkinson’s Disease and Dementia</ce:title><ce:author-group><ce:author><ce:given-name>Laura</ce:given-name><ce:surname>Marsh</ce:surname><ce:degrees>M.D.</ce:degrees><ce:cross-ref refid="cor0005"><ce:sup>⁎</ce:sup></ce:cross-ref></ce:author><ce:author><ce:given-name>Constantine</ce:given-name><ce:surname>Lyketsos</ce:surname><ce:degrees>M.D.</ce:degrees></ce:author><ce:author><ce:given-name>Stephen G.</ce:given-name><ce:surname>Reich</ce:surname><ce:degrees>M.D.</ce:degrees></ce:author><ce:affiliation><ce:textfn>Morris K. Udall Parkinson’s Disease Research Center of Excellence at Johns Hopkins, the Neuropsychiatry Service, Department of Psychiatry and Behavioral Sciences, Baltimore, MD</ce:textfn></ce:affiliation><ce:affiliation><ce:textfn>Movement Disorders Center, Department of Neurology, Johns Hopkins University School of Medicine, Johns Hopkins University, Baltimore, MD</ce:textfn></ce:affiliation><ce:correspondence id="cor0005"><ce:label>⁎</ce:label><ce:text>Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, 600 N Wolfe St. Baltimore, MD 21287.</ce:text></ce:correspondence></ce:author-group><ce:date-received day="27" month="2" year="2001"></ce:date-received><ce:date-revised day="28" month="6" year="2001"></ce:date-revised><ce:date-accepted day="19" month="7" year="2001"></ce:date-accepted><ce:abstract><ce:abstract-sec><ce:simple-para id="spar0005">Psychotic symptoms are a common complication in Parkinson’s disease with dementia. The authors conducted an open-label 6-week trial of olanzapine preceded by a placebo lead-in in five subjects with Parkinson’s disease, mild to moderately severe dementia, and psychosis. Four of the subjects terminated the trial early because of worsening motor function, sedation, or paranoia. There was no improvement in psychotic symptoms, and functional abilities declined significantly. Olanzapine appears to be poorly tolerated in patients with Parkinson’s disease, psychotic symptoms, and dementia.</ce:simple-para></ce:abstract-sec></ce:abstract></head><body><ce:sections><ce:para id="par0005">Psychosis develops in up to 40% of patients with Parkinson’s disease (PD) and is the most common cause of nursing home placement.<ce:cross-ref refid="bib0005"><ce:sup>1</ce:sup></ce:cross-ref> Although antiparkinsonian therapies are often implicated, advanced disease and cognitive impairment are additional specific risks for psychosis<ce:cross-ref refid="bib0010"><ce:sup>2</ce:sup></ce:cross-ref> Trials of antipsychotics in those with PD typically focus on drug-induced psychosis and exclude patients with dementia, whose response to antipsychotic medications may differ from PD patients without dementia. Because PD patients with dementia and psychosis are a significant source of morbidity, caregiver burden, and complex management issues,<ce:cross-ref refid="bib0015"><ce:sup>3</ce:sup></ce:cross-ref> treatment guidelines are needed.</ce:para><ce:para id="par0010">This study examined the efficacy and safety of olanzapine for the treatment of psychosis in PD patients with dementia. Olanzapine is an atypical neuroleptic with a low affinity for striatal D<ce:inf>2</ce:inf> receptors and a reduced propensity for causing extrapyramidal symptoms.<ce:cross-ref refid="bib0020"><ce:sup>4</ce:sup></ce:cross-ref> Its clinical qualities are similar to clozapine, an atypical neuroleptic that is generally effective and tolerated for psychosis in patients with PD.<ce:cross-ref refid="bib0025"><ce:sup>5</ce:sup></ce:cross-ref> However, olanzapine does not have hematological side effects that require weekly blood monitoring.</ce:para><ce:section id="sec0005"><ce:section-title>Method</ce:section-title><ce:section id="sec0010"><ce:section-title>Subjects</ce:section-title><ce:para id="par0015">Subjects were recruited from the Johns Hopkins Movement Disorders Clinic and had idiopathic PD based on the United Kingdom Brain Bank Criteria,<ce:cross-ref refid="bib0030"><ce:sup>6</ce:sup></ce:cross-ref> dementia secondary to PD based on DSM-IV criteria,<ce:cross-ref refid="bib0035"><ce:sup>7</ce:sup></ce:cross-ref> and hallucinations and/or delusions for at least 4 weeks before study entry that were not accounted for by another medical or psychiatric cause. Subjects were recruited only after their antiparkinsonian medications were reduced to the lowest dose tolerated with respect to motor function. All participants or their caregivers provided informed consent.</ce:para></ce:section><ce:section id="sec0015"><ce:section-title>Trial Procedures</ce:section-title><ce:para id="par0020">Assessments were conducted at screening; baseline; and Weeks 1, 2, 4, and 6. Antiparkinsonian medications were stable for at least 7 days before patient screening, which included a physical examination, electrocardiogram, urinalysis, complete blood count, and a comprehensive chemistry panel. After a 4-to 8-day single-blind placebo lead-in, subjects who maintained a score <ce:hsp sp="0.25"></ce:hsp>><ce:hsp sp="0.25"></ce:hsp>2 on the Schedule for the Assessment of Positive Symptoms (SAPS) Hallucinations or Delusions subscale<ce:cross-ref refid="bib0040"><ce:sup>8</ce:sup></ce:cross-ref> were started on olanzapine (2.5<ce:hsp sp="0.25"></ce:hsp>mg qhs). If treatment response plateaued and the patient was tolerating olanzapine, the dose was increased in 2.5-mg increments every 3 days (up to 15.0<ce:hsp sp="0.25"></ce:hsp>mg qhs). Dose reductions occurred whenever side effects were intolerable.</ce:para><ce:para id="par0025">Efficacy was measured as the change in psychosis severity using the SAPS score. Secondary efficacy measures included the Brief Psychiatric Rating Scale, Neuropsychiatric Inventory symptom severity and caregiver distress scores,<ce:cross-ref refid="bib0045"><ce:sup>9</ce:sup></ce:cross-ref> and hours of sleep between 2100 and 0900. The primary safety measure was the Unified Parkinson’s Disease Rating Scale (UPDRS) motor score.<ce:cross-ref refid="bib0050"><ce:sup>10</ce:sup></ce:cross-ref> Additional safety assessments included orthostatic blood pressure and functional and cognitive abilities based on the UPDRS Activities of Daily Living Scale and Mini-Mental State Exam.<ce:cross-ref refid="bib0055"><ce:sup>11</ce:sup></ce:cross-ref></ce:para></ce:section><ce:section id="sec0020"><ce:section-title>Statistical Analysis</ce:section-title><ce:para id="par0030">With SPSS software, we used Wilcoxon’s signed rank tests to test the change in rating scales from baseline to final assessment (last observation carried forward). The small sample size limits interpretation of these analyses.</ce:para></ce:section></ce:section><ce:section id="sec0025"><ce:section-title>Results</ce:section-title><ce:section id="sec0030"><ce:section-title>Medication Dosage and Study Completion</ce:section-title><ce:para id="par0035">Five patients (2 women, 3 men) with mild to moderately severe dementia met enrollment criteria and received olanzapine (<ce:cross-ref refid="tbl0005">Table 1</ce:cross-ref><ce:float-anchor refid="tbl0005"></ce:float-anchor>). No patient tolerated olanzapine at a dose greater than 2.5<ce:hsp sp="0.25"></ce:hsp>mg because of worsened parkinsonism, though the maximum dose prescribed was 7.5<ce:hsp sp="0.25"></ce:hsp>mg for one night. Subject 2 requested termination on Day 14 because of delusional ideation about the investigators that developed after he took tramadol. Subject 3 was withdrawn on Day 15 because of worsening motor function and psychosis. Subject 4 was withdrawn on Day 7 because of worsening motor function and excessive sedation. Subject 5 was hospitalized for delirium, dehydration, and a urinary tract infection after being found unresponsive on the floor of her home. She had not taken olanzapine for at least 24 hours. Subject 1 completed the trial but discontinued olanzapine approximately 2 months later because of worsening motor function. The study was terminated because of these events and published reports<ce:cross-ref refid="bib0065"><ce:sup>13</ce:sup></ce:cross-ref> of olanzapine use in PD patients raising safety concerns.</ce:para></ce:section><ce:section id="sec0035"><ce:section-title>Medication Effects</ce:section-title><ce:para id="par0040">The UPDRS Activities of Daily Living subscore worsened (<ce:italic>P</ce:italic><ce:hsp sp="0.25"></ce:hsp><<ce:hsp sp="0.25"></ce:hsp>0.05) from baseline to the final observation (<ce:cross-ref refid="fig0005">Figure 1</ce:cross-ref><ce:float-anchor refid="fig0005"></ce:float-anchor> and <ce:cross-ref refid="tbl0005">Table 1</ce:cross-ref>). Caregivers reported initial improvements in nocturnal sleep and psychotic symptom intensity, but there were no statistically significant differences in hours of sleep, vital signs, caregiver distress, cognition, psychiatric symptom ratings, or motor function.</ce:para></ce:section></ce:section><ce:section id="sec0040"><ce:section-title>Discussion</ce:section-title><ce:para id="par0045">Psychosis is a common and challenging complication of PD. Pharmacotherapy is especially difficult because most neuroleptic medications aggravate parkinsonism.<ce:cross-ref refid="bib0015"><ce:sup>3</ce:sup></ce:cross-ref> Atypical antipsychotics such as olanzapine have a lower risk of extrapyramidal side effects and may be useful in patients with PD. However, this small open-label trial was associated with functional decline, suggesting that olanzapine has limited utility for the treatment of psychosis in patients with PD and mild to moderately severe dementia.</ce:para><ce:para id="par0050">Two earlier open-label studies suggest olanzapine is safe and effective for psychosis in PD patients, but other studies describe poor tolerance. Dosage titration schedules and patient selection might explain the different outcomes. An initial study<ce:cross-ref refid="bib0070"><ce:sup>14</ce:sup></ce:cross-ref> included only patients without dementia and a starting dose of 1.0<ce:hsp sp="0.25"></ce:hsp>mg, which is not available commercially and may have limited motor side effects. The final dose ranged from 2 to 15<ce:hsp sp="0.25"></ce:hsp>mg (mean±SD<ce:hsp sp="0.25"></ce:hsp>=<ce:hsp sp="0.25"></ce:hsp>6.5±3.9<ce:hsp sp="0.25"></ce:hsp>mg) and the study allowed for increases in antiparkinsonian medications after 50 days. A subsequent study<ce:cross-ref refid="bib0075"><ce:sup>15</ce:sup></ce:cross-ref> also reported a favorable response to an 8-week trial of olanzapine starting at 5<ce:hsp sp="0.25"></ce:hsp>mg in PD patients with and without dementia. The patients with dementia were more likely to withdraw from the trial, primarily because of sedation. Other anecdotal, retrospective, and prospective studies show unacceptable motor side effects with olanzapine.<ce:cross-ref refid="bib0065"><ce:sup>13</ce:sup></ce:cross-ref><ce:sup>,</ce:sup><ce:cross-ref refid="bib0080"><ce:sup>16</ce:sup></ce:cross-ref><ce:sup>,</ce:sup><ce:cross-refs refid="bib0085 bib0090 bib0095"><ce:sup>17–19</ce:sup></ce:cross-refs> In the only controlled trial, olanzapine (mean<ce:hsp sp="0.25"></ce:hsp>±<ce:hsp sp="0.25"></ce:hsp>SD peak dose<ce:hsp sp="0.25"></ce:hsp>=<ce:hsp sp="0.25"></ce:hsp>11.4±3.5<ce:hsp sp="0.25"></ce:hsp>mg/day) caused significant worsening of parkinsonism, particularly gait and bradykinesia, relative to clozapine (mean peak dose<ce:hsp sp="0.25"></ce:hsp>=<ce:hsp sp="0.25"></ce:hsp>25.8<ce:hsp sp="0.25"></ce:hsp>±<ce:hsp sp="0.25"></ce:hsp>13.5<ce:hsp sp="0.25"></ce:hsp>mg/day).<ce:cross-ref refid="bib0100"><ce:sup>20</ce:sup></ce:cross-ref></ce:para><ce:para id="par0070">Subjects in our study were terminated from the trial because of worsening parkinsonism or medical complications. Although the effect of olanzapine on motor signs was not significant, the sample size is small and fluctuating motor signs in patients with PD (as shown in <ce:cross-ref refid="fig0005">Figure 1</ce:cross-ref>) further confound their assessment.<ce:cross-ref refid="bib0105"><ce:sup>21</ce:sup></ce:cross-ref> Functional abilities, however, declined significantly. This corresponded to greater motor impairment in most cases, but incipient medical conditions may also have contributed. For most patients, enhanced parkinsonian effects occurred within the first 2 weeks, but the onset of medication intolerance varied. A possible explanation for individual differences in extrapyramidal side effects is that disease stage or dose of antiparkinsonian medications influence the amount of striatal synaptic dopamine available to compete with olanzapine for the D<ce:inf>2</ce:inf> receptor. Although it is a weak D<ce:inf>2</ce:inf> antagonist, olanzapine binds relatively tightly to the D<ce:inf>2</ce:inf> receptor and is less likely to be rapidly displaced by dopamine, especially in the setting of reduced dopamine levels.<ce:cross-ref refid="bib0110"><ce:sup>22</ce:sup></ce:cross-ref> In contrast, some other atypical antipsychotics with higher dissociation constants (e.g., clozapine or quetiapine) are more loosely bound to the D<ce:inf>2</ce:inf> receptor and are readily displaced by dopamine, thereby reducing the risk of extrapyramidal signs.</ce:para><ce:para id="par0055">The clinicopathological correlates of dementia and psychosis in PD are poorly understood, but extranigral pathology is presumed.<ce:cross-ref refid="bib0115"><ce:sup>23</ce:sup></ce:cross-ref> Olanzapine antagonism at other receptors potentially contributes to nonmotor side effects, including sedation, delirium, and orthostasis, and patients with dementia tend to be more vulnerable to these side effects. However, olanzapine did not have adverse cognitive effects in our series, as Mini-Mental State Exam scores were generally stable. Recent studies show that olanzapine has procholinergic properties, mediated via 5-HT-6 receptor activity, that potentially offset any adverse anticholinergic effects.<ce:cross-ref refid="bib0120"><ce:sup>24</ce:sup></ce:cross-ref><ce:sup>,</ce:sup><ce:cross-ref refid="bib0125"><ce:sup>25</ce:sup></ce:cross-ref></ce:para><ce:para id="par0060">Most atypical antipsychotic medications (olanzapine, risperidone, quetiapine, and clozapine) have been used with variable success for PD-related psychosis.<ce:cross-ref refid="bib0130"><ce:sup>26</ce:sup></ce:cross-ref> The results of this small open-label trial, despite its shortcomings, lead us to recommend that olanzapine and other atypical neuroleptics should be used with caution in PD patients with psychosis and dementia because of their potential to aggravate motor deficits and confusion, which already contribute to functional impairment and caregiver burden.</ce:para></ce:section></ce:sections><ce:acknowledgment><ce:para id="par0065">The authors thank Lisette Bunting, R.N., M.Sc.N. for study coordination. This study was supported by Eli Lilly, Inc, the Morris K. Udall Parkinson’ s <ce:grant-sponsor id="gs0005">Disease Research Center of Excellence at Johns Hopkins</ce:grant-sponsor> (<ce:grant-number refid="gs0005">NIH P50-NS-58377</ce:grant-number>), and the <ce:grant-sponsor id="gs0010">General Clinical Research Center at Johns Hopkins University School of Medicine</ce:grant-sponsor> (<ce:grant-sponsor id="gs0015">National Center for Research Resources</ce:grant-sponsor>/<ce:grant-number refid="gs0015">NIH M01-RR00052</ce:grant-number>).</ce:para></ce:acknowledgment></body><tail><ce:bibliography id="bibl0005"><ce:section-title>References</ce:section-title><ce:bibliography-sec id="bibs0005"><ce:bib-reference id="bib0005"><ce:label>1.</ce:label><sb:reference><sb:contribution><sb:authors><sb:author><ce:given-name>C.G.</ce:given-name><ce:surname>Goetz</ce:surname></sb:author><sb:author><ce:given-name>G.T.</ce:given-name><ce:surname>Stebbins</ce:surname></sb:author></sb:authors><sb:title><sb:maintitle>Risk factors for nursing home placement in advanced Parkinson’s disease</sb:maintitle></sb:title></sb:contribution><sb:host><sb:issue><sb:series><sb:title><sb:maintitle>Neurology</sb:maintitle></sb:title><sb:volume-nr>43</sb:volume-nr></sb:series><sb:date>1993</sb:date></sb:issue><sb:pages><sb:first-page>2227</sb:first-page><sb:last-page>2229</sb:last-page></sb:pages></sb:host></sb:reference></ce:bib-reference><ce:bib-reference id="bib0010"><ce:label>2.</ce:label><sb:reference><sb:contribution><sb:authors><sb:author><ce:given-name>D.</ce:given-name><ce:surname>Aarsland</ce:surname></sb:author><sb:author><ce:given-name>J.P.</ce:given-name><ce:surname>Larsen</ce:surname></sb:author><sb:author><ce:given-name>J.L.</ce:given-name><ce:surname>Cummings</ce:surname></sb:author><sb:et-al></sb:et-al></sb:authors><sb:title><sb:maintitle>Prevalence and clinical correlates of psychotic symptoms in Parkinson Disease: a community-based study</sb:maintitle></sb:title></sb:contribution><sb:host><sb:issue><sb:series><sb:title><sb:maintitle>Arch Neurol</sb:maintitle></sb:title><sb:volume-nr>56</sb:volume-nr></sb:series><sb:date>1999</sb:date></sb:issue><sb:pages><sb:first-page>595</sb:first-page><sb:last-page>601</sb:last-page></sb:pages></sb:host></sb:reference></ce:bib-reference><ce:bib-reference id="bib0015"><ce:label>3.</ce:label><sb:reference><sb:contribution><sb:authors><sb:author><ce:given-name>M.J.</ce:given-name><ce:surname>Henderson</ce:surname></sb:author><sb:author><ce:given-name>J.D.C.</ce:given-name><ce:surname>Mellers</ce:surname></sb:author></sb:authors><sb:title><sb:maintitle>Psychosis in Parkinson’s disease: “between a rock and a hard place.”</sb:maintitle></sb:title></sb:contribution><sb:host><sb:issue><sb:series><sb:title><sb:maintitle>International Review of Psychiatry</sb:maintitle></sb:title><sb:volume-nr>12</sb:volume-nr></sb:series><sb:date>2000</sb:date></sb:issue><sb:pages><sb:first-page>319</sb:first-page><sb:last-page>334</sb:last-page></sb:pages></sb:host></sb:reference></ce:bib-reference><ce:bib-reference id="bib0020"><ce:label>4.</ce:label><sb:reference><sb:contribution><sb:authors><sb:author><ce:given-name>C.M</ce:given-name><ce:surname>Beasley</ce:surname></sb:author><sb:author><ce:given-name>G.</ce:given-name><ce:surname>Tollefson</ce:surname></sb:author><sb:author><ce:given-name>P.</ce:given-name><ce:surname>Tran</ce:surname></sb:author><sb:et-al></sb:et-al></sb:authors><sb:title><sb:maintitle>Olanzapine versus placebo and haloperidol: acute phase results of the North American double-blind olanzapine trial</sb:maintitle></sb:title></sb:contribution><sb:host><sb:issue><sb:series><sb:title><sb:maintitle>Neuropsychopharmacology</sb:maintitle></sb:title><sb:volume-nr>14</sb:volume-nr></sb:series><sb:date>1996</sb:date></sb:issue><sb:pages><sb:first-page>111</sb:first-page><sb:last-page>123</sb:last-page></sb:pages></sb:host></sb:reference></ce:bib-reference><ce:bib-reference id="bib0025"><ce:label>5.</ce:label><sb:reference><sb:contribution><sb:authors><sb:collaboration>Parkinson Study Group</sb:collaboration></sb:authors><sb:title><sb:maintitle>Low-dose clozapine for the treatment of drug-induced psychosis in Parkinson’s disease</sb:maintitle></sb:title></sb:contribution><sb:host><sb:issue><sb:series><sb:title><sb:maintitle>N Engl J Med</sb:maintitle></sb:title><sb:volume-nr>340</sb:volume-nr></sb:series><sb:date>1999</sb:date></sb:issue><sb:pages><sb:first-page>757</sb:first-page><sb:last-page>763</sb:last-page></sb:pages></sb:host></sb:reference></ce:bib-reference><ce:bib-reference id="bib0030"><ce:label>6.</ce:label><sb:reference><sb:contribution><sb:authors><sb:author><ce:given-name>A.J.</ce:given-name><ce:surname>Hughes</ce:surname></sb:author><sb:author><ce:given-name>S.E.</ce:given-name><ce:surname>Daniel</ce:surname></sb:author><sb:author><ce:given-name>L.</ce:given-name><ce:surname>Kilford</ce:surname></sb:author><sb:et-al></sb:et-al></sb:authors><sb:title><sb:maintitle>Accuracy of clinical diagnosis of idiopathic Parkinson’s disease: a clinico-pathological study of 100 cases</sb:maintitle></sb:title></sb:contribution><sb:host><sb:issue><sb:series><sb:title><sb:maintitle>J Neurol Neurosurg Psychiatry</sb:maintitle></sb:title><sb:volume-nr>55</sb:volume-nr></sb:series><sb:date>1992</sb:date></sb:issue><sb:pages><sb:first-page>181</sb:first-page><sb:last-page>184</sb:last-page></sb:pages></sb:host></sb:reference></ce:bib-reference><ce:bib-reference id="bib0035"><ce:label>7.</ce:label><sb:reference><sb:contribution><sb:authors><sb:collaboration>American Psychiatric Association</sb:collaboration></sb:authors></sb:contribution><sb:host><sb:edited-book><sb:title><sb:maintitle>Diagnostic and Statistical Manual of Mental Disorders</sb:maintitle></sb:title><sb:edition>4th Edition</sb:edition><sb:date>1994</sb:date><sb:publisher><sb:name>American Psychiatric Association</sb:name><sb:location>Washington, DC</sb:location></sb:publisher></sb:edited-book></sb:host></sb:reference></ce:bib-reference><ce:bib-reference id="bib0040"><ce:label>8.</ce:label><sb:reference><sb:contribution><sb:authors><sb:author><ce:given-name>N.</ce:given-name><ce:surname>Andreasen</ce:surname></sb:author><sb:author><ce:given-name>S.</ce:given-name><ce:surname>Olsen</ce:surname></sb:author></sb:authors><sb:title><sb:maintitle>Negative vs positive schizophrenia: definition and validation</sb:maintitle></sb:title></sb:contribution><sb:host><sb:issue><sb:series><sb:title><sb:maintitle>Arch Gen Psychiatry</sb:maintitle></sb:title><sb:volume-nr>39</sb:volume-nr></sb:series><sb:date>1982</sb:date></sb:issue><sb:pages><sb:first-page>789</sb:first-page><sb:last-page>794</sb:last-page></sb:pages></sb:host></sb:reference></ce:bib-reference><ce:bib-reference id="bib0045"><ce:label>9.</ce:label><sb:reference><sb:contribution><sb:authors><sb:author><ce:given-name>J.L.</ce:given-name><ce:surname>Cummings</ce:surname></sb:author></sb:authors><sb:title><sb:maintitle>The Neuropsychiatric Inventory: assessing psychopathology in dementia patients</sb:maintitle></sb:title></sb:contribution><sb:host><sb:issue><sb:series><sb:title><sb:maintitle>Neurology</sb:maintitle></sb:title><sb:volume-nr>48</sb:volume-nr></sb:series><sb:date>1997</sb:date></sb:issue><sb:pages><sb:first-page>10</sb:first-page><sb:last-page>16</sb:last-page></sb:pages></sb:host></sb:reference></ce:bib-reference><ce:bib-reference id="bib0050"><ce:label>10.</ce:label><sb:reference><sb:contribution><sb:authors><sb:author><ce:given-name>S.</ce:given-name><ce:surname>Fahn</ce:surname></sb:author><sb:author><ce:given-name>R.L.</ce:given-name><ce:surname>Elton</ce:surname></sb:author></sb:authors><sb:title><sb:maintitle>Members of the UPDRS Development Committee: Unified Parkinson’s disease rating scale</sb:maintitle></sb:title></sb:contribution><sb:host><sb:edited-book><sb:editors><sb:editor><ce:given-name>S.</ce:given-name><ce:surname>Fahn</ce:surname></sb:editor><sb:editor><ce:given-name>C.D.</ce:given-name><ce:surname>Marsden</ce:surname></sb:editor><sb:editor><ce:given-name>M.</ce:given-name><ce:surname>Goldstein</ce:surname></sb:editor></sb:editors><sb:title><sb:maintitle>Recent Developments in Parkinson’s Disease II</sb:maintitle></sb:title><sb:date>1987</sb:date><sb:publisher><sb:name>Macmillan</sb:name><sb:location>New York</sb:location></sb:publisher></sb:edited-book></sb:host></sb:reference></ce:bib-reference><ce:bib-reference id="bib0055"><ce:label>11.</ce:label><sb:reference><sb:contribution><sb:authors><sb:author><ce:given-name>M.F.</ce:given-name><ce:surname>Folstein</ce:surname></sb:author><sb:author><ce:given-name>S.E.</ce:given-name><ce:surname>Folstein</ce:surname></sb:author><sb:author><ce:given-name>P.R.</ce:given-name><ce:surname>McHugh</ce:surname></sb:author></sb:authors><sb:title><sb:maintitle>“Mini-mental state”: a practical method for grading the cognitive state of patients for the clinician</sb:maintitle></sb:title></sb:contribution><sb:host><sb:issue><sb:series><sb:title><sb:maintitle>J Psychiatr Res</sb:maintitle></sb:title><sb:volume-nr>12</sb:volume-nr></sb:series><sb:date>1975</sb:date></sb:issue><sb:pages><sb:first-page>189</sb:first-page><sb:last-page>198</sb:last-page></sb:pages></sb:host></sb:reference></ce:bib-reference><ce:bib-reference id="bib0060"><ce:label>12.</ce:label><sb:reference><sb:contribution><sb:authors><sb:author><ce:given-name>S.</ce:given-name><ce:surname>Mattis</ce:surname></sb:author></sb:authors><sb:title><sb:maintitle>Dementia Rating Scale (DRS) Professional Manual</sb:maintitle></sb:title></sb:contribution><sb:host><sb:book><sb:date>1988</sb:date><sb:publisher><sb:name>Psychological Assessment Resources</sb:name><sb:location>Odessa FL</sb:location></sb:publisher></sb:book></sb:host></sb:reference></ce:bib-reference><ce:bib-reference id="bib0065"><ce:label>13.</ce:label><sb:reference><sb:contribution><sb:authors><sb:author><ce:given-name>E.S.</ce:given-name><ce:surname>Molho</ce:surname></sb:author><sb:author><ce:given-name>S.A.</ce:given-name><ce:surname>Factor</ce:surname></sb:author></sb:authors><sb:title><sb:maintitle>Worsening of motor features of parkinsonism with olanzapine</sb:maintitle></sb:title></sb:contribution><sb:host><sb:issue><sb:series><sb:title><sb:maintitle>Mov Disord</sb:maintitle></sb:title><sb:volume-nr>14</sb:volume-nr></sb:series><sb:date>1999</sb:date></sb:issue><sb:pages><sb:first-page>1014</sb:first-page><sb:last-page>1016</sb:last-page></sb:pages></sb:host></sb:reference></ce:bib-reference><ce:bib-reference id="bib0070"><ce:label>14.</ce:label><sb:reference><sb:contribution><sb:authors><sb:author><ce:given-name>E.C.</ce:given-name><ce:surname>Wolters</ce:surname></sb:author><sb:author><ce:given-name>E.N.H.</ce:given-name><ce:surname>Jansen</ce:surname></sb:author><sb:author><ce:given-name>H.G.</ce:given-name><ce:surname>Tuynman-Qua</ce:surname></sb:author><sb:et-al></sb:et-al></sb:authors><sb:title><sb:maintitle>Olanzapine in the treatment of dopaminomimetic psychosis in patients with Parkinson’s disease</sb:maintitle></sb:title></sb:contribution><sb:host><sb:issue><sb:series><sb:title><sb:maintitle>Neurology</sb:maintitle></sb:title><sb:volume-nr>47</sb:volume-nr></sb:series><sb:date>1996</sb:date></sb:issue><sb:pages><sb:first-page>1085</sb:first-page><sb:last-page>1087</sb:last-page></sb:pages></sb:host></sb:reference></ce:bib-reference><ce:bib-reference id="bib0075"><ce:label>15.</ce:label><sb:reference><sb:contribution><sb:authors><sb:author><ce:given-name>D.</ce:given-name><ce:surname>Aarsland</ce:surname></sb:author><sb:author><ce:given-name>J.P.</ce:given-name><ce:surname>Larsen</ce:surname></sb:author><sb:author><ce:given-name>N.G.</ce:given-name><ce:surname>Lim</ce:surname></sb:author><sb:et-al></sb:et-al></sb:authors><sb:title><sb:maintitle>Olanzapine for psychosis in patients with Parkinson’s disease with and without dementia</sb:maintitle></sb:title></sb:contribution><sb:host><sb:issue><sb:series><sb:title><sb:maintitle>J Neuropsychiatry Clin Neurosci</sb:maintitle></sb:title><sb:volume-nr>11</sb:volume-nr></sb:series><sb:date>1999</sb:date></sb:issue><sb:pages><sb:first-page>392</sb:first-page><sb:last-page>394</sb:last-page></sb:pages></sb:host></sb:reference></ce:bib-reference><ce:bib-reference id="bib0080"><ce:label>16.</ce:label><sb:reference><sb:contribution><sb:authors><sb:author><ce:given-name>J.M.</ce:given-name><ce:surname>Graham</ce:surname></sb:author><sb:author><ce:given-name>J.D.</ce:given-name><ce:surname>Sussman</ce:surname></sb:author><sb:author><ce:given-name>K.S.</ce:given-name><ce:surname>Ford</ce:surname></sb:author><sb:et-al></sb:et-al></sb:authors><sb:title><sb:maintitle>Olanzapine in the treatment of hallucinosis in idiopathic Parkinson’s disease: a cautionary note</sb:maintitle></sb:title></sb:contribution><sb:host><sb:issue><sb:series><sb:title><sb:maintitle>J Neurol Neurosurg Psychiatry</sb:maintitle></sb:title><sb:volume-nr>65</sb:volume-nr></sb:series><sb:date>1998</sb:date></sb:issue><sb:pages><sb:first-page>774</sb:first-page><sb:last-page>777</sb:last-page></sb:pages></sb:host></sb:reference></ce:bib-reference><ce:bib-reference id="bib0085"><ce:label>17.</ce:label><sb:reference><sb:contribution><sb:authors><sb:author><ce:given-name>J.</ce:given-name><ce:surname>Friedman</ce:surname></sb:author></sb:authors><sb:title><sb:maintitle>Olanzapine in the treatment of dopaminomimetic psychosis in patients with Parkinson’s disease (letter)</sb:maintitle></sb:title></sb:contribution><sb:host><sb:issue><sb:series><sb:title><sb:maintitle>Neurology</sb:maintitle></sb:title><sb:volume-nr>50</sb:volume-nr></sb:series><sb:date>1998</sb:date></sb:issue><sb:pages><sb:first-page>1195</sb:first-page><sb:last-page>1196</sb:last-page></sb:pages></sb:host></sb:reference></ce:bib-reference><ce:bib-reference id="bib0090"><ce:label>18.</ce:label><sb:reference><sb:contribution><sb:authors><sb:author><ce:given-name>J.H.</ce:given-name><ce:surname>Friedman</ce:surname></sb:author><sb:author><ce:given-name>S.</ce:given-name><ce:surname>Goldstein</ce:surname></sb:author><sb:author><ce:given-name>C.</ce:given-name><ce:surname>Jacques</ce:surname></sb:author></sb:authors><sb:title><sb:maintitle>Substituting clozapine for olanzapine in psychiatrically stable Parkinson’s disease patients: results of an open label pilot study</sb:maintitle></sb:title></sb:contribution><sb:host><sb:issue><sb:series><sb:title><sb:maintitle>Clin Neuropharmacol</sb:maintitle></sb:title><sb:volume-nr>21</sb:volume-nr></sb:series><sb:date>1998</sb:date></sb:issue><sb:pages><sb:first-page>285</sb:first-page><sb:last-page>288</sb:last-page></sb:pages></sb:host></sb:reference></ce:bib-reference><ce:bib-reference id="bib0095"><ce:label>19.</ce:label><sb:reference><sb:contribution><sb:authors><sb:author><ce:given-name>F.J.</ce:given-name><ce:surname>Jimenez-Jimenez</ce:surname></sb:author><sb:author><ce:given-name>A.</ce:given-name><ce:surname>Tallon-Barranco</ce:surname></sb:author><sb:author><ce:given-name>M.</ce:given-name><ce:surname>Orti-Pareja</ce:surname></sb:author><sb:et-al></sb:et-al></sb:authors><sb:title><sb:maintitle>Olanzapine can worsen parkinsonism</sb:maintitle></sb:title></sb:contribution><sb:host><sb:issue><sb:series><sb:title><sb:maintitle>Neurology</sb:maintitle></sb:title><sb:volume-nr>50</sb:volume-nr></sb:series><sb:date>1998</sb:date></sb:issue><sb:pages><sb:first-page>1183</sb:first-page><sb:last-page>1184</sb:last-page></sb:pages></sb:host></sb:reference></ce:bib-reference><ce:bib-reference id="bib0100"><ce:label>20.</ce:label><sb:reference><sb:contribution><sb:authors><sb:author><ce:given-name>C.G.</ce:given-name><ce:surname>Goetz</ce:surname></sb:author><sb:author><ce:given-name>L.M.</ce:given-name><ce:surname>Blasucci</ce:surname></sb:author><sb:author><ce:given-name>S.</ce:given-name><ce:surname>Leurgans</ce:surname></sb:author><sb:et-al></sb:et-al></sb:authors><sb:title><sb:maintitle>Olanzapine and clozapine: comparative effects on motor function in hallucinating PD patients</sb:maintitle></sb:title></sb:contribution><sb:host><sb:issue><sb:series><sb:title><sb:maintitle>Neurology</sb:maintitle></sb:title><sb:volume-nr>55</sb:volume-nr></sb:series><sb:date>2000</sb:date></sb:issue><sb:pages><sb:first-page>789</sb:first-page><sb:last-page>794</sb:last-page></sb:pages></sb:host></sb:reference></ce:bib-reference><ce:bib-reference id="bib0105"><ce:label>21.</ce:label><sb:reference><sb:contribution><sb:authors><sb:author><ce:given-name>A.E.</ce:given-name><ce:surname>Lang</ce:surname></sb:author><sb:author><ce:given-name>S.</ce:given-name><ce:surname>Fahn</ce:surname></sb:author></sb:authors><sb:title><sb:maintitle>Assessment of Parkinson’s disease</sb:maintitle></sb:title></sb:contribution><sb:host><sb:edited-book><sb:editors><sb:editor><ce:given-name>T.L.</ce:given-name><ce:surname>Munsat</ce:surname></sb:editor></sb:editors><sb:title><sb:maintitle>Quantification of Neurologic Deficit</sb:maintitle></sb:title><sb:date>1989</sb:date><sb:publisher><sb:name>Butterworth</sb:name><sb:location>Boston</sb:location></sb:publisher></sb:edited-book></sb:host></sb:reference></ce:bib-reference><ce:bib-reference id="bib0110"><ce:label>22.</ce:label><sb:reference><sb:contribution><sb:authors><sb:author><ce:given-name>P.</ce:given-name><ce:surname>Seeman</ce:surname></sb:author><sb:author><ce:given-name>S.</ce:given-name><ce:surname>Kapur</ce:surname></sb:author></sb:authors><sb:title><sb:maintitle>Olanzapine binding to dopamine receptors in vitro and in vivo</sb:maintitle></sb:title></sb:contribution><sb:host><sb:edited-book><sb:editors><sb:editor><ce:given-name>P.V.</ce:given-name><ce:surname>Tran</ce:surname></sb:editor><sb:et-al></sb:et-al></sb:editors><sb:title><sb:maintitle>Olanzapine (Zyprexa): A Novel Antipsychotic</sb:maintitle></sb:title><sb:date>2000</sb:date><sb:publisher><sb:name>Lippincott Williams and Wilkins</sb:name><sb:location>Philadelphia, PA</sb:location></sb:publisher></sb:edited-book></sb:host></sb:reference></ce:bib-reference><ce:bib-reference id="bib0115"><ce:label>23.</ce:label><sb:reference><sb:contribution><sb:authors><sb:author><ce:given-name>L.S.</ce:given-name><ce:surname>Forno</ce:surname></sb:author></sb:authors><sb:title><sb:maintitle>Neuropathology of Parkinson’s disease</sb:maintitle></sb:title></sb:contribution><sb:host><sb:issue><sb:series><sb:title><sb:maintitle>J Neuropathol Exp Neurol</sb:maintitle></sb:title><sb:volume-nr>55</sb:volume-nr></sb:series><sb:date>1996</sb:date></sb:issue><sb:pages><sb:first-page>259</sb:first-page><sb:last-page>272</sb:last-page></sb:pages></sb:host></sb:reference></ce:bib-reference><ce:bib-reference id="bib0120"><ce:label>24.</ce:label><sb:reference><sb:contribution><sb:authors><sb:author><ce:given-name>J.</ce:given-name><ce:surname>Kennedy</ce:surname></sb:author><sb:author><ce:given-name>B.</ce:given-name><ce:surname>Basson</ce:surname></sb:author><sb:author><ce:given-name>A.</ce:given-name><ce:surname>Zagar</ce:surname></sb:author><sb:et-al></sb:et-al></sb:authors><sb:title><sb:maintitle>The effects of olanzapine on Alzheimer’s disease assessment scale scores in patients with mild to moderate Alzheimer’s disease with psychosis and behavioral disturbances</sb:maintitle></sb:title></sb:contribution><sb:host><sb:issue><sb:series><sb:title><sb:maintitle>J Am Geriatr Soc</sb:maintitle></sb:title><sb:volume-nr>48</sb:volume-nr></sb:series><sb:date>2000</sb:date></sb:issue><sb:pages><sb:first-page>S111</sb:first-page></sb:pages></sb:host></sb:reference></ce:bib-reference><ce:bib-reference id="bib0125"><ce:label>25.</ce:label><sb:reference><sb:contribution><sb:authors><sb:author><ce:given-name>F.</ce:given-name><ce:surname>Bymaster</ce:surname></sb:author><sb:author><ce:given-name>J.F.</ce:given-name><ce:surname>Falcone</ce:surname></sb:author></sb:authors><sb:title><sb:maintitle>Decreased binding affinity of olanzapine and clozapine for clonal human muscarinic receptor subtypes in intact CHO cells in physiological medium</sb:maintitle></sb:title></sb:contribution><sb:host><sb:issue><sb:series><sb:title><sb:maintitle>Eur J Pharmacol</sb:maintitle></sb:title><sb:volume-nr>390</sb:volume-nr></sb:series><sb:date>2000</sb:date></sb:issue><sb:pages><sb:first-page>245</sb:first-page><sb:last-page>248</sb:last-page></sb:pages></sb:host></sb:reference></ce:bib-reference><ce:bib-reference id="bib0130"><ce:label>26.</ce:label><sb:reference><sb:contribution><sb:authors><sb:author><ce:given-name>R.H.J.</ce:given-name><ce:surname>Workman</ce:surname></sb:author><sb:author><ce:given-name>D.</ce:given-name><ce:surname>Stoebner</ce:surname></sb:author><sb:author><ce:given-name>R.G.</ce:given-name><ce:surname>Raicu</ce:surname></sb:author></sb:authors><sb:title><sb:maintitle>Management of psychosis and agitation in demented elderly with Parkinson’s disease</sb:maintitle></sb:title></sb:contribution><sb:host><sb:issue><sb:series><sb:title><sb:maintitle>Clinical Geriatrics</sb:maintitle></sb:title><sb:volume-nr>8</sb:volume-nr></sb:series><sb:date>2000</sb:date></sb:issue><sb:pages><sb:first-page>76</sb:first-page><sb:last-page>83</sb:last-page></sb:pages></sb:host></sb:reference></ce:bib-reference></ce:bibliography-sec></ce:bibliography></tail></article></istex:document></istex:metadataXml><mods version="3.6"><titleInfo lang="en"><title>Olanzapine for the Treatment of Psychosis in Patients With Parkinsons Disease and Dementia</title></titleInfo><titleInfo type="alternative" lang="en" contentType="CDATA"><title>Olanzapine for the Treatment of Psychosis in Patients With Parkinson</title></titleInfo><name type="personal"><namePart type="given">Laura</namePart><namePart type="family">Marsh</namePart><namePart type="termsOfAddress">M.D.</namePart><affiliation>Morris K. Udall Parkinsons Disease Research Center of Excellence at Johns Hopkins, the Neuropsychiatry Service, Department of Psychiatry and Behavioral Sciences, Baltimore, MDMovement Disorders Center, Department of Neurology, Johns Hopkins University School of Medicine, Johns Hopkins University, Baltimore, MD</affiliation><description>Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, 600 N Wolfe St. Baltimore, MD 21287.</description><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Constantine</namePart><namePart type="family">Lyketsos</namePart><namePart type="termsOfAddress">M.D.</namePart><affiliation>Morris K. Udall Parkinsons Disease Research Center of Excellence at Johns Hopkins, the Neuropsychiatry Service, Department of Psychiatry and Behavioral Sciences, Baltimore, MDMovement Disorders Center, Department of Neurology, Johns Hopkins University School of Medicine, Johns Hopkins University, Baltimore, MD</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Stephen G.</namePart><namePart type="family">Reich</namePart><namePart type="termsOfAddress">M.D.</namePart><affiliation>Morris K. Udall Parkinsons Disease Research Center of Excellence at Johns Hopkins, the Neuropsychiatry Service, Department of Psychiatry and Behavioral Sciences, Baltimore, MDMovement Disorders Center, Department of Neurology, Johns Hopkins University School of Medicine, Johns Hopkins University, Baltimore, MD</affiliation><role><roleTerm type="text">author</roleTerm></role></name><typeOfResource>text</typeOfResource><genre type="research-article" displayLabel="Full-length article"></genre><originInfo><publisher>ELSEVIER</publisher><dateIssued encoding="w3cdtf">2001</dateIssued><dateValid encoding="w3cdtf">2001-07-19</dateValid><dateModified encoding="w3cdtf">2001-06-28</dateModified><copyrightDate encoding="w3cdtf">2011</copyrightDate></originInfo><language><languageTerm type="code" authority="iso639-2b">eng</languageTerm><languageTerm type="code" authority="rfc3066">en</languageTerm></language><physicalDescription><internetMediaType>text/html</internetMediaType></physicalDescription><abstract>Psychotic symptoms are a common complication in Parkinsons disease with dementia. The authors conducted an open-label 6-week trial of olanzapine preceded by a placebo lead-in in five subjects with Parkinsons disease, mild to moderately severe dementia, and psychosis. Four of the subjects terminated the trial early because of worsening motor function, sedation, or paranoia. There was no improvement in psychotic symptoms, and functional abilities declined significantly. Olanzapine appears to be poorly tolerated in patients with Parkinsons disease, psychotic symptoms, and dementia.</abstract><note type="content">Figure 1: </note><note type="content">Table 1: Demographic features and effects of olanzapine on secondary outcome measures</note><relatedItem type="host"><titleInfo><title>Psychosomatics</title></titleInfo><titleInfo type="abbreviated"><title>PSYM</title></titleInfo><genre type="Journal">journal</genre><originInfo><dateIssued encoding="w3cdtf">200111</dateIssued></originInfo><identifier type="ISSN">0033-3182</identifier><identifier type="PII">S0033-3182(01)X7027-8</identifier><part><date>200111</date><detail type="volume"><number>42</number><caption>vol.</caption></detail><detail type="issue"><number>6</number><caption>no.</caption></detail><extent unit="issue pages"><start>453</start><end>537</end></extent><extent unit="pages"><start>477</start><end>481</end></extent></part></relatedItem><identifier type="istex">F7524C782E5194C3851FAFC6DC9A9B0EB916ED3F</identifier><identifier type="DOI">10.1176/appi.psy.42.6.477</identifier><identifier type="PII">S0033-3182(01)70454-9</identifier><accessCondition type="use and reproduction" contentType="">© 2011The Academy of Psychosomatic Medicine</accessCondition><recordInfo><recordContentSource>ELSEVIER</recordContentSource><recordOrigin>The Academy of Psychosomatic Medicine, ©2011</recordOrigin></recordInfo></mods></metadata><enrichments><istex:catWosTEI uri="https://api.istex.fr/document/F7524C782E5194C3851FAFC6DC9A9B0EB916ED3F/enrichments/catWos"><teiHeader><profileDesc><textClass><classCode scheme="WOS">PSYCHIATRY</classCode><classCode scheme="WOS">PSYCHOLOGY</classCode></textClass></profileDesc></teiHeader></istex:catWosTEI></enrichments><serie></serie></istex></record>Pour manipuler ce document sous Unix (Dilib)
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